BVHS Weekend Column: Parenting During the COVID-19 Pandemic

The American Academy of Pediatrics has an excellent website that is devoted to helping parents – HealthyChildren.org.

By Cheryl Huffman, MD, Pediatrics

Pediatrician Dr. Cheryl Huffman


Being a parent is extremely rewarding; however, it can also be very demanding. The current COVID-19 pandemic is forcing many parents “out of their comfort zone.” Almost all children are out of school at this time. So, while it may seem like an “extended summer vacation,” it comes with additional burdens to parents.

Parents are being asked to help teach their children when most were not trained as teachers. In addition, several subjects – especially math – are no longer “taught the same way” as parents learned, making it increasingly difficult for parents to help their children. Summer vacation comes with plenty of extra time for outdoor activities and sports – and for most students, social distancing makes those activities unavailable at this time. For many families, there are the added burdens of financial stress, as more and more businesses close down due to the pandemic.

Fortunately, help is available for parents. The American Academy of Pediatrics has an excellent website that is devoted to helping parents – HealthyChildren.org. It is a wealth of information, which is supported by research data. Almost every imaginable topic is included, and the search option is easy to use.

Due to the COVID-19 pandemic, several new topics have been added. A few that you may find helpful are “Positive Parenting & COVID-19. 10 Tips to Help Keep the Calm at Home,” “Working and Learning from Home During the COVID-19 Outbreak,” and “Getting Children Outside While Social Distancing for COVID-19.”

We are all hopeful that the pandemic will soon be behind us and that the world will get back to “normal.” But that “normal” will almost certainly be a “new normal.” HealthyChildren.org can provide help at that time as well.

 

 

 

BVHS Weekend Column: COVID-19, Mental Health and Physical Well-Being

Practitioners across all specialties will almost always suggest physical activity for the treatment of varying health conditions…..

By Brook Crawford, APRN-CNP, Family Medicine Certified Nurse Practitioner, Blanchard Valley Hospital

Brook Crawford

 

Let’s face it, COVID-19 has not been easy on anyone. Since March 2020, we have experienced restrictions, stay-at-home orders, mandates and a plethora of other new “experiences” that most of us have never had in our lifetimes. With these “experiences” come different emotions, thoughts and problems including, but not limited to, anxiety, restlessness, insomnia and increased stress. Studies completed in January and February 2020 in China found that anxiety developed in the general population at a rate of approximately 29%. A study in March 2020 of United States residents determined that at least 36% of Americans felt that COVID-19 was having a serious impact on their mental health.

Exercise is a commonly suggested, yet underutilized tool for health improvement and maintenance. Practitioners across all specialties will almost always suggest physical activity for the treatment of varying health conditions, physical and psychological in nature. Activities such as Yoga and Tai Chi are mindful, meditation-based exercises that involve focusing on the task at hand and take you away from those thoughts that may be causing stress and anxiety in your life. These are specialty activities which many people are unsure how to perform. A simpler activity that most people are capable of completing and has been shown to be equally effective is brisk walking. The 2018 Physical Activity Guidelines suggest 150 minutes of moderate to vigorous activity each week. Walking at a pace that is difficult, but still possible, to maintain conversation is a great way to gauge exercise intensity. These minutes can be accrued consecutively or in “chunks” throughout the day.

Physical activity and exercise cause a release of hormones, including dopamine, serotonin and norepinephrine, which affects the brain to increase mood and positive emotions. Simply taking a 10-15 minute walk when you are feeling stressed, anxious or overwhelmed can be great to help clear your head and give your body the hormones it needs to be able to handle the stress and anxiety you may be experiencing.

You should always check with your primary care provider before starting any exercise program to ensure your safety and discuss any concerns that you may have regarding activity. Taking this step, though, is the first of many towards a healthier lifestyle, improved emotions and coping with the stress and anxiety of this current situation we are living in.

We may not know how long this will last, the unpredictable problems ahead or what life may be like once we are able to move forward. However, we can take control of our physical and mental health one day at a time and put ourselves in the best position to be successful regardless of what may be going on in the world around us. Reach out to your healthcare provider, ask for help, encourage others and go take a walk. Your brain will thank you.

 

Tom Zhou, MD Joins ENT & Allergy Specialists of Northwest Ohio

Office in Findlay, Ohio

 Dr. Tom Zhou has joined the medical staff at ENT & Allergy Specialists of Northwest Ohio, part of Blanchard Valley Medical Practices. Dr. Zhou is an otolaryngologist and will treat diseases of the head and neck. His office is located at 1110 W. Main Cross St. Suite G, Findlay, Ohio.

Dr. Tom Zhou, otolaryngologist

 

Dr. Zhou received his medical degree from the University of Minnesota Medical School (Minneapolis, Minnesota). He then completed his residency at The Ohio State University Wexner Medical Center (Columbus, Ohio).

Dr. Zhou is accepting new and existing patients. For more information or to schedule an appointment, call 419.423.5492.

BVHS Weekend Column: Gallstones

About 10 percent of the population (25 million Americans) have gallstones ……

Gallstones, by Thomas Strigle, MD, General Surgery, Surgical Associates of Northwest Ohio

Dr. Thomas Strigle,MD-General Surgery


Gallstones are precipitations (collections) of bile that form into stones that range in size from sand crystals to golf balls. They usually form in the gallbladder which is a sac-like organ sitting beneath the liver on the right side of the abdomen. The gallbladder’s purpose is to store the bile that the liver creates. 

Bile travels through ducts to empty into the intestine and helps digest the fatty foods we eat. Gallstones occur from an unbalanced collection of cholesterol, lecithin and bile salts in the bile. Some diseases can also cause gallstones such as sickle cell anemia. About 10 percent of the population (25 million Americans) have gallstones. 

Unfortunately, the gallstones can block the outlet of the gallbladder or ducts, giving rise to inflammation and infection of the gallbladder, liver, bile ducts or pancreas. Rarely do gallstones cause gallbladder cancer, which is rare in the first place. Usually, only symptomatic gallstones need to be treated. Asymptomatic gallstones are typically watched and observed.

Gallstones can cause moderate to severe pain on the right upper portion of the abdomen as well as below the breastbone at the top of the stomach. The pain can go to the right shoulder or to the back. They can be associated with nausea, vomiting, belching and even sometimes jaundice. They are predominately found in females (65%). Other risk factors are being over 40 years of age, being overweight, having a sedentary lifestyle, undergoing rapid weight loss, being pregnant, using female hormones, as well as having a family history. Gallstones are commonly diagnosed with an ultrasound though other modalities can be used as well.  

Treatment usually requires the removal of the gallbladder (cholecystectomy). The body still functions well since the liver can make an abundant supply of bile to help with digestion. Occasionally after gallbladder surgery, people can have looser stools. This usually resolves over time but can be treated with medicine. A cholecystectomy is performed most of the time using a laparoscope thru small incisions. This generally allows patients to go home the same day and recover faster. Gallstones blocking the ducts may require an endoscopy (scope down your throat) to remove the stones as well. Some gallstones can be treated with medicine if the patient is not a surgical candidate, but it can take months or up to a year to dissolve the stones with a frequent recurrence rate. Prevention of gallstones includes maintaining a healthy weight, regular meals and exercise, a high fiber diet with less red meat and if overweight a slow weight loss. If you have any questions or concerns about your gallbladder you should have a discussion with your primary care provider about it.

 

BVHS Weekend Column: Protecting Yourself

From Sexually Transmitted Infections (STIs)….

By Malary McBride, APRN-CNP, Certifed Nurse Practitioner
Blanchard Valley Obstetrics & Gynecology

Malary McBride, Certified Nurse Practitioner


September is Sexual Health Awareness Month. Did you know that one in two sexually active persons will contract a sexually transmitted infection (STI) by age 25? However, this is not the only age group affected by STIs. STIs affect people of all ages and backgrounds. There are nearly 20 million new cases each year in the U.S. alone. Protecting yourself from STIs and getting screened for STIs is important. The only way to know if you have an STI is to be tested!

STDs (sexually transmitted diseases) was the term we used to refer to diseases spread through sexual contact. You may start to hear healthcare providers use the term sexually transmitted infections instead. When we hear “disease,” most people would think that sounds like a medical problem. However, the most common STDs are asymptomatic (there are no signs/symptoms).  Furthermore, the sexually transmitted bacteria or virus can be referred to as an “infection.” 

While you may not be able to eliminate the risk of STIs completely, there are many ways to reduce the risk of contracting STIs. This includes abstinence, mutual monogamy (only having intercourse with your partner) or limiting partners, barrier methods (such as male or female condoms), and avoiding alcohol and recreational drug use (which reduces our ability to make safe sex decisions).  Communication with your sexual partner(s) is imperative, and remember you have the right to say “No.” Having sex is a decision both partners should be comfortable with.

Talking to a healthcare provider about sexual health can be embarrassing or intimidating for some patients. However, understanding your body and talking about safe sex with ways to protect yourself is very important. That’s what we are here for! Be smart and get tested.

 

 

Blanchard Valley Health System Auxiliary 2020 Scholarship Recipients

Ten $1,000.00 scholarships were awarded to students interested in pursuing a health-related career….

The Blanchard Valley Health System Auxiliary recently awarded ten $1,000.00 scholarships to students in the Hancock County area, interested in pursuing a health-related career.

The 2020 Hospital Auxiliary scholarship winners include: Claire Eiden (Ottawa Glandorf High School), pursuing a degree at University of Toledo, Abigail Hatch (Liberty Benton High School), pursuing a degree at University of Findlay, Lilly Hodson (Findlay High School), pursuing a degree at The Ohio State University, Allison Kennard (Findlay High School), pursuing a degree at The Ohio State University, Chloe Kin (Liberty Benton High School), pursing a degree at The Ohio State University, Abagayle Omlor (Findlay High School), pursuing a degree at Case Western Reserve, Madison Parker (Van Buren High School), pursuing a degree at The Ohio State University, Addison Schafer (Columbus Grove High School), pursuing a degree at Cedarville University, Justen Stoner (Arcadia High School), pursuing a degree at The Ohio State University, and Ava Welch (Findlay High School), pursuing a degree at Xavier University.

Monies for the scholarship fund are derived from the annual membership dues of members of the Auxiliary. The number of scholarships awarded annually will depend on the amount contributed by Auxiliary members.

To learn more about scholarships offered through Blanchard Valley Health System, please visit https://www.bvhealthsystem.org/scholarships.

Blanchard Valley Health System Acquires the Findlay Surgery Center

“This acquisition strongly supports our mission, vision and values to better serve our community.”

Blanchard Valley Health System (BVHS) recently acquired the Findlay Surgery Center (FSC), located at 1709 Medical Blvd. in Findlay, thereby adding an outpatient surgery center to its continuum of services.

 

The FSC will continue to offer surgical and procedural services in orthopedics, podiatry, general surgery, ENT (otolaryngology), pain management, plastic and cosmetic surgery, ophthalmology, gynecology, urology, endoscopic and oral surgery.


“The FSC has provided excellent services to the community for more than 20 years,” stated Scott Malaney, president and CEO of BVHS. “We look forward to working together on this initiative and learning from each other.”


The goal of the acquisition is to retain the surgery center’s efficiency and convenience to patients and physicians, while making the resources of BVHS available.

 

“This acquisition strongly supports our mission, vision and values to better serve our community. The FSC has earned its reputation for delivering high quality care and we are proud to bring them into the BVHS family of professionals,” added Malaney.

 

The staff currently at the FSC will remain at that location and operations will function “business as usual.” There are no expected disruptions in service to patients.

 

BVHS and the FSC participate with most local and national commercial insurers. It is the patient’s responsibility to notify their insurance company of an upcoming procedure and to confirm whether the facilities are in-network or out-of-network facility.

 

“This is an exciting venture that prioritizes the health needs of our community,” added Cheryl Cunningham, administrator at the FSC. “We have worked in partnership with BVHS for many years and are looking forward to aligning the FSC with a health system that consistently provides world class care.”

For more information about services at Blanchard Valley Health System or the Findlay Surgery Center, please visit bvhealthsystem.org.

Blanchard Valley Health System Provides COVID-19 Testing

Guidance for Patients and Employers….

Blanchard Valley Health System (BVHS) is encouraging individuals to work with their primary care providers to order the COVID-19 test, if needed. BVHS is collecting outpatient COVID-19 samples with a provider order at the Findlay and Bluffton campuses. These samples are collected by appointment only.

Individuals who have been exposed to COVID-19 or are having symptoms related to COVID-19 are also able to be evaluated at Physicians Plus Urgent Care and COVID-19 testing may be ordered and completed onsite.

Employers within the community should contact Well at Work by calling 419.425.5121. Experienced team members will provide guidance on what COVID-19 testing and evaluations BVHS can provide.

BVHS is experiencing a prolonged turn-around time for COVID-19 test results due to the increase in testing across the nation and the impact this has on testing supplies and processing of samples. Results for COVID-19 testing may take 7-10 days at this point in time.

If a patient’s COVID-19 test result is positive, the ordering physician will notify the patient. Patients should not call BVHS or their local public health departments for test results.

Additionally, all COVID-19 test results are available on the BVHS MyHealth patient portal. If you do not have a patient portal account established, then please visit bvhealthsystem.org/patientportal or call the Patient Portal Help Line at 1.877.621.8014.

 

Blanchard Valley Hospital Named One of America’s Best Hospitals

This award signifies BVH ranks in the top 5% of U.S. hospitals in the nation for patient safety. Congratulations!….

Blanchard Valley Hospital, a division of Blanchard Valley Health System (BVHS), has been recognized with multiple America’s Best Hospitals Women’s Choice Awards for 2020. The Women’s Choice Awards recognizes BVHS as one of America’s Best Hospitals for cancer care, stroke care and patient safety. This award signifies BVH ranks in the top 5% of U.S. hospitals in the nation for patient safety.

Blanchard Valley Hospital Pavillion

“To receive these awards is truly an honor,” stated Scott Malaney, president and CEO of BVHS. “This recognition shows we strive to provide exceptional care and do so with compassion and integrity. We are committed to following the safety practices we have in place to ensure each of our patients are in safe hands every time they enter a BVHS facility.”

The Women’s Choice Award for Best Hospitals is a coveted credential that identifies the nation’s best hospitals based on criteria that includes relevant clinical performance, patient satisfaction and appropriate accreditations. The Best Hospitals Award demonstrates exceptional ratings, providing the highest level of care and commitment to their patients’ health and well-being.

To learn more about Blanchard Valley Health System and services offered, please visit bvhealthsystem.org.

Bluffton Hospital donates meals

 to Bluffton Family Recreation Summer Kid’s Camp…..

Bluffton Hospital, a division of Blanchard Valley Health System (BVHS), has donated funds to provide meals to the Bluffton Family Recreation (BFR) 2020 Summer Kids’ Camp. The meals will feed children ages 5-12 enrolled in their program, each week throughout the summer.

“BFR summer camp provides children with the opportunity to experience a variety of indoor and outdoor activities. Keeping the children active, it is important to have nutritious meals,” shared Daniel Tinch, executive director of Bluffton Family Recreation. “We are thankful that Bluffton Hospital has provided our campers access to healthy foods throughout their busy summer.”

Nicole Keuneke, director of operations at Bluffton Hospital shared, “We are grateful to team up with the BFR to supply meals to children at the summer camp for yet another year. Providing healthy meals to a program that keeps children active is just part of Bluffton Hospital’s role in caring for the health of the community.”

For more information about Bluffton Hospital, please visit bvhealthsystem.org.

BVHS Weekend Column: Lyme Disease

The risk of getting Lyme disease from a tick bite is very low (about 1 in 100) if the tick is removed before it is engorged…..

LymeDisease, by  Jeffrey Eiden, MD, Family Medicine, Putnam County Primary Care



It is tick time again! Along with the warmer weather that gets us outside, hiking and tromping through the woods, comes the risk of exposure to ticks. When we think of ticks, we often think of Lyme disease. Here is a brief review of what you should know about ticks, preventing and treating tick bites, as well as some information about Lyme disease.

A tick is a small arachnid that is a parasite. Ticks require the blood of another organism to survive. They attach to a host, often a mammal, feed on blood, detach and repeat when they need another meal. Not all ticks carry diseases, but some do. There are 16 known human diseases transmitted by ticks. The best approach is to avoid ticks if possible or at least remove them soon after they attach.

Ticks are most active during warm weather. They are most often in wooded or brushy areas or in high grass. Be aware that you might encounter ticks when in this type of area. If you venture into an area that is likely to have ticks present, you should consider using a tick repellent. Most insect repellents also repel ticks. The recommendation is to use an insect repellent that contains DEET. Clothing, boots and tents can also be pre-treated with 0.5% permethrin which also repels ticks. Limiting exposed skin by covering it with clothing and by tucking pants into socks keeps ticks from finding a place to attach.

If a tick does attach, it is best to remove it as soon as possible. Get in the habit of checking for ticks after spending time outdoors. Look for ticks on clothes and shoes. Check pets also, as ticks can attach to them and then gain access to your home. It is also wise to bathe or shower within two hours of returning inside and to check over all your skin to be sure there are no ticks attached. Children should be thoroughly checked by parents.

When a tick is found on skin, remove it. The best way to remove a tick is to grasp it firmly with fine-tipped tweezers and pull away from the skin. It works best if the tip of the tweezers is as close to the skin as possible. Steady pressure should remove the tick. Avoid twisting or jerking. If the tick does not come off in one piece, remove the pieces left behind if possible. There are some “tricks” for removing ticks that are passed around, including using a match or nail polish. These do not work. Use the tweezers and pull.

Suppose you do find a tick that has attached to your skin. Remove it as above. Do not panic but do be alert for any signs or symptoms of tick-borne illness. These would include fever, chills, muscle aches and in some cases, rash. If any of these symptoms develop, contact your primary care provider for instructions.

Shifting to Lyme disease, the risk of getting Lyme disease from a tick bite is very low (about 1 in 100) if the tick is removed before it is engorged. This is why it is so important to find and remove ticks as soon as possible.

There is consideration for using a single dose of antibiotic to prevent Lyme disease after a tick bite, but this is only recommended in specific situations. The tick would need to be identified as a deer tick, as this is the only type of tick known to transmit Lyme disease. Deer ticks have black legs, which distinguishes them from other types of ticks. The tick should have been attached for 36 hours or more, as indicated by time since exposure or degree of engorgement. The antibiotic should be given within 72 hours of tick removal. The tick bite should have occurred in an area where at least 20% of ticks are infected with the bacteria that causes Lyme disease. This is an issue in parts of New England and parts of Pennsylvania, New Jersey, New York, Minnesota and Wisconsin. In Ohio, although we have deer ticks and some carry Lyme disease, we are not yet at area with this level of tick infection.

Another approach to preventing full-blown Lyme disease is to treat at the first sign of a rash that indicates possible infection. This rash is distinctive. It occurs at the site of the tick bite and is salmon to red-colored and circular. One-third of the time, it can have a clear area in the center that makes it look like a bull’s eye or target. The rash, called erythema migrans, tends to expand outward over several days, getting larger and larger. If you have had a tick bite and develop this type of rash where the bite occurred, you should call your primary care provider and be evaluated. Treatment at this point would typically be with a course of an antibiotic like doxycycline, amoxicillin or cefuroxime.

Lyme disease is caused by the body’s immune response to the bacteria Borrelia burgdorferi. The symptoms are divided into different phases, based on length of time since initial infection. The early localized phase of Lyme disease is usually about 7-14 days after the tick bite. It is characterized by the rash of erythema migrans, and symptoms typical of a viral infection, such as fatigue, fever, headache, muscle or joint pain and swollen lymph nodes. The symptoms are not often severe.

The early disseminated phase of Lyme disease occurs days to weeks after the tick bite and is caused by the spread of bacteria through the bloodstream, leading to inflammation in the affected area. There can be involvement of the heart or nervous system. Symptoms of infection in a particular organ are not common, but can be severe.

In addition to early symptoms, there can be a late phase of Lyme disease. This most commonly is seen as inflammation affecting the joint and muscles and happens in 80% of people who did not receive treatment with antibiotics for their early infection. Late Lyme disease can also cause neurologic symptoms, but this is rare.

Post-Lyme disease syndrome is a group of symptoms that can occur chronically after treatment for Lyme disease. The symptoms seen with this are headache, fatigue and joint pain. Because these types of symptoms are common, some people worry that they have post-Lyme disease syndrome even when they do not have a history of having had Lyme disease. It is not helpful to treat the post-Lyme disease syndrome with antibiotics, and it gradually resolves.

The diagnosis of Lyme disease is made based on history of possible exposure to ticks, characteristic signs and symptoms, and the finding of antibodies to Lyme disease on blood testing. The blood tests are not always helpful and should be ordered by a physician/provider after consultation and interpreted considering the patient’s story and symptoms.

As in so many medical conditions, prevention is key and early detection/treatment is the next best option. Watch out for ticks! But get outside and enjoy the warm weather whenever you can. Doctor’s orders. J

 

 

 

Stay at Home Nursing

It is important to know the home care benefits available to you, because the ultimate goal is to be able to receive the care you need…..

 Amidst the COVID-19 pandemic, being able to stay at home to receive nursing care and therapy services may be a newer thought to some. Many aging individuals aren’t aware of the insurance benefits they already have that include in-home care. Those with Medicare as their primary insurance are typically covered 100 percent for home care services, as long as certain criteria are met. One of these is being “homebound.” It may sound like a scary term, but it is less restrictive than it sounds.

Being homebound is actually two-fold. First, a person must need help to leave their home. This help can be from a device (wheelchair, walker or cane), from another person (spouse, child, other caregiver), or special transportation. This help can be needed because of a physical illness or injury, or because of a diagnosis such as Dementia, that makes the person unsafe to leave the home alone. The person may also have a condition that could become worse if they leave the home, such as a wound infection or lung infection. Secondly, the person must have a normal inability to leave the home, and leaving and returning home requires a “considerable and taxing” effort.

Knowing that, it is also important to know that being homebound does not mean the person is never allowed to leave home. Medicare does allow outings for religious services, doctor’s appointments, hair appointments, short walks around the block, short drives away from home, family reunions and events, funerals, graduations and attending adult daycare at accredited facilities. Patients can also be homebound and still drive themselves to appointments.

Many Medicare advantage plans follow the same rules for in-home services, and most Medicaid policies do not require homebound status at all.

Other criteria that are needed for home health care are: a doctor’s prescription for in-home care, a doctor who is willing to sign all home-care orders and a “skilled” need for in-home nursing or therapy (meaning there are things the nurse or therapist needs to teach the patient or caregiver to help keep the patient safe and out of the hospital). This need can be related to teaching about a diagnosis, medications, wound care, ostomy care, home equipment, therapy home exercise programs or anything else necessary to help keep the patient out of the hospital.

It is important to know the home care benefits available to you, because the ultimate goal is to be able to receive the care you need while staying safe and staying at home.

by Jenna Cotterman MOT, OTR/L, COQS, Home Health Therapy Manager,Bridge Home Health & Hospice